Search Results (2,242)

Background: Heart failure (HF) affects not only the cardiovascular system but also mental health. The majority of patients with HF experience symptoms of mental disorders, such as depression, which are proportionally related to the severity of HF. This results in a significant comorbidity of HF, which might be associated with poor clinical outcomes, including decreased health-related quality of life (HRQOL). In Türkiye, data concerning the extent of this complication among outpatients with HF are limited. Therefore, the aim of this study was to assess the prevalence of depression in outpatients with HF and consequently the HRQOL; the secondary aim was to identify the related factors contributing to the incidence of depression and HRQOL in patients with HF in Bursa, Türkiye. Methods: An outpatient, descriptive, observational, cross-sectional study was conducted in a cardiology outpatient clinic in Bursa Province, Türkiye, between September and December 2022. The study was conducted via a validated questionnaire consisting of four sections. Depression was measured using the Beck Depression Inventory (BDI) scale, and the HRQOL of HF patients was evaluated using the Turkish version of the Minnesota Living with HF Questionnaire (MLHFQ). Simple linear regression and multiple linear regression analyses were used to determine the effects of variables. Limitations of the study include its design as a descriptive, observational, cross-sectional study from a single center that relies on self-reported data. Results: A total of 166 patients were enrolled, with a mean age of 64.96 ± 11.33 years. Nearly half of the participants had moderate or severe depression (33.1% and 15.7%, respectively). The mean MLHFQ score of the study participants was 54.15 ± 18.20. Patients suffering from severe depression had the lowest HRQOL (71.46 ± 12.4). There was a significant increase in depression level, and a decrease in HRQOL in patients with a duration of HF diagnosis of more than 3 years (p = 0.001), a number of HF hospitalizations (p = 0.001), and those diagnosed with NYHA class IV (p = 0.001). Multiple linear regression analysis revealed a significant relationship between the duration of HF disease, number of comorbidities, number of medications used, and BDI [(0.30 < r: 0.31/0.43/0.43 ≤ 0.70), respectively]. The simple linear regression analysis revealed that the BDI has positive and significant explanatory power for the MLHFQ (F: 168.29; R²: 0.51; t: 12.97; p < 0.001), and 51% of the change in the MLHFQ score is recorded by the BDI (R²: 0.51). Conclusions: The results of this study revealed that comorbid depression and HRQOL are closely related. This was observed in nearly half of the patients with HF, who had comorbid moderate and severe depression, which is associated with poor HRQOL. The factors associated with high depression and poor HRQOL were the duration of HF diagnosis of more than 3 years, an increased number of HF hospitalizations, polypharmacy, and NYHA class IV diagnoses. Full article

Background: Calcium (Ca) and magnesium (Mg) are essential micronutrients integral to metabolic processes and cardiovascular health. Emerging evidence suggests that the dietary Ca:Mg ratio may influence chronic disease risk, yet variability in this ratio across diverse demographic groups and its relationship to body composition and vitamin D status remain unclear. Methods: Dietary intakes of Ca and Mg were assessed using validated Food Frequency Questionnaires (FFQs) and body composition was quantified via Dual-energy X-ray Absorptiometry (DXA) scans. Relationships between dietary Ca:Mg ratios and demographics, body composition parameters (lean and fat mass), and vitamin D and parathyroid hormone (PTH) levels were examined statistically using SPSS ver. 29.0 and R ver. 4.5.1 (2025) employing Kruskal–Wallis, regression, and moderated mediation analyses. Results: We examined 155 healthy adults with a mean age of 36.6 ± 12.5 years. Only 16.8% had adequate intakes of Mg compared with 45.8% who had adequate dietary Ca intakes. Significant differences in the Ca:Mg ratio were observed across racial groups (p = 0.023) and age groups (p = 0.017). South Asian Indians exhibited the highest median Ca:Mg ratio (4.83), whereas African Americans exhibited the lowest (2.67). Interestingly, our moderated mediation analysis indicated that African Americans were the most sensitive to the impact of PTH changes on the balance of Ca:Mg (indirect effect = −0.762, 95% CI [−1.298, −0.234]), indicating that even slight shifts in their Ca:Mg balances cause significant elevation in the PTH, which, in turn, leads to lowering of their vitamin D levels. Young adults (ages 18–29) had the highest median Ca:Mg ratio (4.73). No statistically significant differences were detected based on Gender (p = 0.425 and BMI (p = 0.744) on Ca:Mg ratios. Additionally, dietary Ca:Mg ratios were positively associated with sPTH in males (r = 0.203, p < 0.05), but not with body composition. Conclusion: Important variations in dietary Ca:Mg ratios exist across racial and age demographics, notably among young adults, and specific ethnic groups exhibited elevated ratios. Tailored nutritional interventions may be necessary for these populations to optimize Ca:Mg balance and support metabolic and cardiovascular health outcomes in these populations. Full article

In Italy, access to public dental care is limited, and the characteristics of patients seeking hospital-based services are poorly described. A single-centre retrospective cross-sectional study was conducted, including all individuals attending their first appointment at the public Dental Clinic of Bari University Hospital (Southern Italy) between 1 January and 31 December 2023. Demographic and clinical variables, comorbidities, reasons for consultation, and travel distance from residence were retrieved from electronic records and analysed. Among 1361 patients (49% male; mean age 47.8 ± 23.3 years), most attended for oral surgery (35%) or oral pathology (17%), while other specialties accounted for the remaining visits. Many patients presented with multiple systemic conditions, particularly cardiovascular and metabolic diseases; however, a sizeable proportion were young, apparently healthy individuals who did not meet national eligibility criteria for publicly funded dental care. The dental clinic served a wide catchment area, including referrals from other regions. Documentation on education and behavioural risk factors was frequently incomplete. Overall, these findings show that complex oral medicine and oral surgery needs are concentrated in a small number of hospital clinics and support the expansion of Italian public dental services and improvements in routine data collection. Full article

Coronary artery disease (CAD) remains the leading cause of cardiovascular morbidity and mortality worldwide, with plaque composition and morphology being as key determinants of disease progression and clinical outcomes. Accurate plaque characterization is essential for risk stratification and therapeutic decision-making, yet conventional image interpretation is limited by inter-observer variability and time-intensive workflows. Artificial intelligence (AI) models have emerged as a transformative tool for automated coronary plaque analysis across multiple imaging modalities. AI-driven models demonstrate high diagnostic accuracy for plaque detection, segmentation, quantification, and vulnerability assessment. Integration of AI-derived imaging biomarkers with clinical risk scores can further enhance prediction of major adverse cardiovascular events and supports personalized management. These advances position AI-enhanced imaging as a powerful adjunct for both invasive and non-invasive evaluation of CAD. Despite its promise, important barriers to widespread clinical adoption remain, including data heterogeneity, algorithmic bias, limited model transparency, insufficient prospective validation, regulatory challenges, and incomplete integration into clinical workflows. Addressing these challenges will be essential to ensure safe, generalizable, and cost-effective implementation of AI in routine cardiovascular care. Full article

Background: Childhood obesity represents the most common nutritional and metabolic disorder in industrialized countries and constitutes a major public health concern. In Italy, 20–25% of school-aged children are overweight and 10–14% are obese, with marked regional variability. Excess adiposity in childhood is frequently associated with hypertension, dyslipidemia, insulin resistance, and non-alcoholic fatty liver disease (NAFLD), predisposing to future cardiovascular disease (CVD). Objective: To investigate anthropometric indicators of cardiometabolic risk in 810 children and adolescents aged 7–17 years who underwent assessment for competitive sports eligibility at the Sports Medicine Unit of Modena, evaluate baseline knowledge of cardiovascular health aligned with ESC, AAP (2023), and EASO guidelines. Methods: 810 children and adolescents aged 7–17 years undergoing competitive sports eligibility assessment at the Sports Medicine Unit of Modena underwent evaluation of BMI percentile, waist circumference (WC), waist-to-height ratio (WHtR), and blood pressure. Cardiovascular knowledge and lifestyle habits were assessed via a previously used questionnaire. Anthropometric parameters, blood pressure (BP), and lifestyle-related knowledge and behaviors were assessed using standardized procedures. Overweight and obesity were defined according to WHO BMI-for-age percentiles. Elevated BP was classified based on the 2017 American Academy of Pediatrics age-, sex-, and height-specific percentiles. Statistical analyses included descriptive statistics, group comparisons, chi-square tests with effect size estimation, correlation analyses, and multivariable logistic regression models. Results: Overall, 22% of participants were overweight and 14% obese. WHtR > 0.5 was observed in 28% of the sample and was more frequent among overweight/obese children (p < 0.001). Elevated BP was detected in 12% of participants with available measurements (n = 769) and was significantly associated with excess adiposity (χ² = 7.21, p < 0.01; Cramér’s V = 0.27). In multivariable logistic regression analyses adjusted for age and sex, WHtR > 0.5 (OR 2.14, 95% CI 1.32–3.47, p = 0.002) and higher sedentary time (OR 1.41 per additional daily hour, 95% CI 1.10–1.82, p = 0.006) were independently associated with elevated BP, whereas BMI percentile lost significance when WHtR was included in the model. Lifestyle knowledge scores were significantly lower among overweight and obese participants compared with normal-weight peers (p < 0.01). Conclusions: WHtR is a sensitive early marker of cardiometabolic risk, often identifying at-risk children missed by BMI alone. Baseline cardiovascular knowledge was suboptimal. The observed gaps in cardiovascular knowledge underscore the importance of integrating anthropometric screening with structured educational interventions to promote healthy lifestyles and long-term cardiovascular prevention. Full article

This study aimed to examine the association between physical activity and individuals’ health status, healthcare utilization, socio-demographic characteristics, and health behaviors in a large representative sample from Northern Greece. A cross-sectional study was conducted involving 1227 participants (47.4% males, mean age 49.94 ± 14.87 years) from Thrace, Greece, selected through a two-stage stratified sampling method. According to the Greek version of IPAQ, participants were classified as inactive/insufficiently active, sufficiently and highly active. Data on socio-demographic, lifestyle, and health-related variables were collected through structured interviews. Multivariate logistic regression analysis was performed to determine the independent effect of physical activity on subjects’ characteristics using SPSS ver. 19. Half of the participants (49.8%) were inactive/insufficiently active, 418 participants (34.1%) were sufficiently active, and 198 participants (16.1%) were highly active. In univariate analysis, smoking (p < 0.001), higher coffee consumption (p = 0.002), higher adherence to Mediterranean diet (p < 0.001), napping during the day (p = 0.017) and short sleep duration (p < 0.001) were associated with lower prevalence of high activity. In adjusted analyses, sufficiently active participants had a lower risk for bad self-rated health (aOR = 0.63), hypertension (aOR = 0.41), dyslipidemia (aOR = 0.42), diabetes (aOR = 0.53), obesity (aOR = 0.61), cardiovascular diseases (aOR = 0.43), anxiety (aOR = 0.65), depression (aOR = 0.56), daily sleepiness (aOR = 0.62), poor sleep quality (aOR = 0.71), as well as for primary (aOR = 0.54) and secondary (aOR = 0.40) healthcare utilization compared to inactive participants. Higher-intensity physical activity did not enhance these beneficial effects of sufficient activity on subjects’ characteristics. Physical inactivity significantly compromises health across multiple domains. Promoting even moderate-intensity physical activity may reduce chronic disease burden and healthcare utilization. Full article

Point-of-care ultrasound (POCUS) is an essential component of emergency medicine, enabling rapid bedside assessment across a wide spectrum of acute conditions. Its effectiveness, however, remains constrained by operator dependency, variable image quality, and time-critical decision-making. Recent advances in artificial intelligence (AI) offer opportunities to augment POCUS by supporting image acquisition, interpretation, and quantitative analysis. This narrative review synthesizes current evidence on AI-enhanced POCUS applications in emergency care, encompassing trauma, non-traumatic emergencies, integrated workflows, resource-limited settings, and education and training. Across trauma settings, AI-assisted POCUS has demonstrated promising performance for automated detection of pneumothorax, hemothorax, and free intraperitoneal fluid, supporting standardized eFAST examinations and rapid triage. In non-traumatic emergencies, AI-enabled cardiovascular, pulmonary, and abdominal applications provide automated measurements and pattern recognition that can approach expert-level performance when image quality is adequate. Integrated AI–POCUS systems and educational tools further highlight the potential to expand ultrasound access, support non-expert users, and standardize training. Nevertheless, important limitations persist, including limited generalizability, dataset bias, device heterogeneity, and uncertain impact on clinical decision-making and patient outcomes. In conclusion, AI-enhanced POCUS is transitioning from proof-of-concept toward early clinical integration in emergency medicine. While current evidence supports its role as a decision-support tool that may enhance consistency and efficiency, widespread adoption will require prospective multicentre validation, development of representative POCUS-specific datasets, vendor-agnostic solutions, and alignment with clinical, ethical, and regulatory frameworks. Full article

Background/Objectives: Insulin resistance and ambulatory blood pressure monitoring (ABPM) abnormalities represent distinct but interrelated pathways contributing to cardiovascular risk. The triglyceride–glucose (TyG) index reflects metabolic burden, whereas arterial load—captured through arterial stiffness, blood pressure variability, and morning surge—reflects hemodynamic instability. Whether the coexistence of these domains identifies a particularly high-risk ambulatory phenotype remains unclear. To evaluate the independent and combined effects of metabolic burden (TyG) and arterial load on circadian blood pressure pattern and short-term systolic blood pressure variability. Methods: This retrospective cross-sectional study included 294 adults who underwent 24 h ABPM. Arterial load was defined using three ABPM-derived indices (high AASI, high SBP-ARV, high morning surge). High metabolic burden was defined as TyG in the upper quartile. The “double-high” phenotype was classified as high TyG plus high arterial load. Primary and secondary outcomes were non-dipping pattern and high SBP variability. Multivariable logistic regression and Firth penalized models were used to assess independent associations. Predictive performance was evaluated using ROC analysis. Results: The double-high phenotype (n = 15) demonstrated significantly higher nighttime SBP, reduced nocturnal dipping, and markedly elevated BP variability. It was the strongest independent predictor of non-dipping (adjusted OR = 42.0; Firth OR = 11.73; both p < 0.001) and high SBP variability (adjusted OR = 41.7; Firth OR = 26.29; both p < 0.001). Arterial load substantially improved model discrimination (AUC = 0.819 for non-dipping; 0.979 for SBP variability), whereas adding TyG to arterial load produced minimal incremental benefit. Conclusions: The coexistence of elevated TyG and increased arterial load defines a distinct hemodynamic endotype characterized by severe circadian blood pressure disruption and exaggerated short-term variability. While arterial load emerged as the principal determinant of adverse ambulatory blood pressure phenotypes, TyG alone demonstrated limited discriminative capacity. These findings suggest that TyG primarily acts as a metabolic modifier, amplifying adverse ambulatory blood pressure phenotypes predominantly in the presence of underlying arterial instability rather than serving as an independent discriminator. Integrating metabolic and hemodynamic domains may therefore improve risk stratification and help identify a small but clinically meaningful subgroup of patients with extreme ambulatory blood pressure dysregulation. Full article

Despite major advances in guideline-directed cardiovascular therapy, residual cardiovascular risk persists, partly driven by oxidative stress, chronic inflammation, endothelial dysfunction, and mitochondrial injury not fully addressed by current drugs. Translation of plant-based cardioprotectants is constrained by preparation-dependent variability in extract chemistry (plant part/cultivar/processing and extraction method), low and variable systemic exposure for key actives (notably curcuminoids and many polyphenols), and clinically relevant safety/interaction considerations (e.g., hepatotoxicity reports with concentrated green tea extracts and antiplatelet-related bleeding-risk considerations for some botanicals). We therefore provide a mechanism- and translation-oriented synthesis of evidence for cardioprotective botanicals, chosen for long-standing traditional use and scientific validation with reproducible experimental data and, where available, human studies, including Crataegus monogyna, Allium sativum, Olea europaea, Ginkgo biloba, Leonurus cardiaca, and Melissa officinalis. Across studies, polyphenols (especially flavonoids and phenolic acids) and organosulfur compounds are most consistently associated with cardioprotection, while terpene-derived constituents and secoiridoids contribute mechanistically in plant-specific settings (e.g., Ginkgo and Olea). Predominantly in experimental models, these agents engage redox-adaptive (Nrf2), mitochondrial (mPTP), endothelial, and inflammatory (NF-κB) pathways, with reported reductions in ischemia–reperfusion injury, oxidative damage, and apoptosis. Clinical evidence remains heterogeneous and is largely confined to short-term studies and surrogate outcomes (blood pressure, lipids, oxidative biomarkers, endothelial function), with scarce data on hard cardiovascular endpoints or event reduction. Priorities include standardized, chemotype-controlled formulations with PK/PD-guided dosing and adequately powered randomized trials that assess safety and herb–drug interactions. Full article

This study presents a standardized method for multimodal monitoring of exercise execution in isolated, confined, and extreme (ICE) environments, addressing the need for reproducible assessment of neuromuscular and cardiovascular responses under space- and equipment-limited conditions. The method integrates wearable surface electromyography (sEMG), inertial measurement units (IMU), and electrocardiography (ECG) to capture muscle activation, movement, and cardiac dynamics during space-efficient exercise. Ten exercises suitable for confined habitats were implemented during analog missions conducted in the DeepLabH03 facility, with feasibility evaluated in a seven-day campaign involving three adult participants. Signals were synchronized using video-verified repetition boundaries, sEMG was normalized to maximum voluntary contraction, and sEMG amplitude- and frequency-domain features were extracted alongside heart rate variability indices. The protocol enabled stable real-time data acquisition, reliable repetition-level segmentation, and consistent detection of muscle-specific activation patterns across exercises. While amplitude-based sEMG indices showed no uniform main effect of exercise, robust exercise-by-muscle interactions were observed, and sEMG mean frequency demonstrated sensitivity to differences in movement strategy. Cardiac measures showed limited condition-specific modulation, consistent with short exercise bouts and small sample size. As a proof-of-concept feasibility study, the proposed protocol provides a practical and reproducible framework for multimodal physiological monitoring of exercise in ICE analogs and other constrained environments, supporting future studies on exercise quality, training load, and adaptive feedback systems. The protocol is designed to support near-real-time monitoring and forms a technical basis for future exercise-quality feedback in confined habitats. Full article

Background/Objectives: Patients with complex chronic disorders constitute a growing share of the general population and are frequently hospitalised for acute care in Internal Medicine Departments. Little is known about long-term rates and predictors of post-discharge mortality, possibly contributing to suboptimal and discontinuous care, including delayed referral to palliative programmes. Methods: To assess the long-term post-discharge mortality of patients admitted to Internal Medicine Departments and its predictors, we analysed a cohort of old, multi-morbid subjects, corresponding to the whole population of patients admitted to an Internal Medicine Department over 12 months (February 2016–March 2017). Public health registries were interrogated to assess the five-year mortality (up to 2022) of patients discharged alive. Results: Post-discharge mortality was 57% at follow-up end, with an early peak rate of 32% at year 1, a 10–14% intermediate rate at years 2–4, and a 7% late rate, approaching expected figures in the general population. Cancer, neurological and liver disorders, and respiratory failure were significantly associated with early and intermediate mortality, while renal disorders, dependence for daily activities, and immunodepression were selectively relevant for death in the first year. Cardiovascular and upper gastrointestinal disorders were associated with late mortality. Surrogate measures of frailty, intensity of care, and patient complexity were also able to predict early-, intermediate-, and late-mortality risk. Conclusions: A relevant fraction of patients hospitalised in Internal Medicine Departments might require palliative care. Dissecting the differential contribution of clinical and healthcare-associated variables for short, medium-, and long-term mortality might facilitate patient management and identify subjects in need of early or simultaneous palliative care. Full article

Background/Objectives: The triglyceride-to-High-density lipoprotein cholesterol (TG/HDL) ratio is an established marker of atherogenic dyslipidaemia and insulin resistance. Although its association with subclinical atherosclerosis has been reported, the relative contributions of long-term TG/HDL burden and visit-to-visit variability to carotid intima media thickness (CIMT) remain unclear. This study aimed to evaluate the differential associations of the longitudinal mean and temporal variability of the TG/HDL ratio with CIMT. Methods: This retrospective single-center observational cohort study included 260 adult patients with at least three years of longitudinal lipid measurements and a standardized carotid ultrasonography assessment. The longitudinal mean TG/HDL ratio and variability indices, including standard deviation, coefficient of variation, average real variability and variability independent of the mean, were calculated. CIMT was measured using B-mode ultrasonography. Associations were assessed using correlation analyses, multivariable linear regression, joint category analyses and stratified analyses according to statin therapy. Results: The longitudinal mean TG/HDL ratio was independently associated with increased CIMT after adjustment for traditional cardiovascular risk factors. In contrast, TG/HDL variability indices showed no independent association with CIMT and did not improve model performance beyond the mean TG/HDL ratio. Restricted cubic spline analysis demonstrated a significant non-linear association between TG/HDL mean and CIMT, suggesting a threshold-dependent relationship. Joint category analyses demonstrated higher CIMT values in groups with elevated TG/HDL mean regardless of variability status. A significant interaction was observed between TG/HDL variability and statin therapy (p for interaction = 0.011). Conclusions: These findings indicate that cumulative exposure to atherogenic dyslipidaemia, reflected by the long-term mean TG/HDL ratio, is more strongly associated with subclinical carotid atherosclerosis than short-term lipid fluctuations. Full article

Background: This study examines how contextual factors influence the match load experienced by U14 athletes. Methods: Ninety-six male players from eight Portuguese regional selection teams were monitored during three official matches each, using WIMU Pro™ inertial devices with ultra-wideband (UWB) tracking systems. Fifteen internal and external load variables were analyzed, including player load/min, high-speed running (HSR), maximum heart rate (HRmax), and high impacts/min. Mixed linear models revealed significant inter-individual variability in all variables, showing sensitivity to match context. Results: Losing teams exhibited higher player load/min. Balanced matches provoked greater cardiovascular and locomotor demands, particularly in HRmax and HSR metrics. Cluster analysis identified three match typologies based on score margin. Team level was strongly associated with final outcomes and quarter performance, reinforcing the predictive value of intra-match consistency. In contrast, match type (score margin) showed limited correlation with team quality or load distribution. Conclusions: These findings demonstrate the multifactorial nature of match load in youth basketball, supporting the implementation of individualized, context-aware training and recovery strategies while guiding long-term athlete development. Full article

Background: Prolonged sitting has been associated with adverse cardiovascular and neuromuscular responses; however, the temporal onset of these acute physiological changes remains unclear. This study aimed to determine the acute effects of prolonged sitting on blood flow, blood pressure, and muscle activity. Methods: A non-controlled clinical trial was conducted with 21 healthy adults (22.5 ± 1.60 years), both male and female. Participants remained seated continuously for three hours, with data collected every 20 min, including infrared thermography, blood pressure, and electromyographic activity. Skin temperature was measured using infrared thermography on the calf region of both legs, and the mean temperature was analyzed. Systolic and diastolic blood pressure were measured using an oscillometric device, and mean arterial pressure was subsequently calculated. Muscle activity was assessed through surface electromyography, using median frequency and root mean square values. Statistical analysis was performed using the Friedman test and the Durbin–Conover post hoc test, along with a subjective trend analysis of each variable over time. Results: A significant reduction was observed in both calf skin temperature and median frequency after 60 min of uninterrupted sitting (p < 0.05). Mean and systolic blood pressure exhibited an increasing trend after 160 min (p < 0.05). Conclusions: The exposure–response data from this study may contribute to the planning of future interventions aimed at refining recommendations for breaking up prolonged sitting periods. Full article

Background/Objectives: Coronary artery disease (CAD) is highly prevalent in patients undergoing vascular surgery and is a major determinant of postoperative morbidity and mortality. Preoperative anemia is a well-recognized risk factor for adverse outcomes, including major adverse cardiac events (MACEs), but its independent impact in patients with CAD undergoing abdominal aortic aneurysm (AAA) repair remains unclear. Methods: We conducted a retrospective cohort study of 410 consecutive patients undergoing open AAA repair at a tertiary vascular center between 2023 and 2025. Preoperative anemia was defined as hemoglobin < 130 g/L and significant CAD as ≥70% luminal narrowing for non-left main disease or ≥50% for left main disease. The primary outcome was MACE (cardiovascular death, myocardial infarction, or stroke) during hospitalization. Baseline covariates included age, sex, diabetes mellitus (DM), chronic kidney disease (CKD), congestive heart failure (CHF), peripheral artery disease (PAD), and other relevant comorbidities. Multivariable logistic regression models were used to evaluate associations of anemia, CAD, and their interaction with MACE. Additionally, a composite risk group was created to examine MACE rates across mutually exclusive subgroups. Results: Among 410 patients, 314 (76.6%) had CAD and 116 (28.3%) had preoperative anemia. Overall, 67 patients (16.3%) experienced MACE. In the reduced model including only anemia and CAD, anemia remained a strong independent predictor of a MACE (OR 4.46, 95% CI 2.57–7.72, p < 0.001), and CAD was also independently associated (OR 2.20, 95% CI 1.00–4.72, p = 0.044). In the full multivariable model adjusting for DM, CHF, CKD, PAD, and age, anemia was the strongest predictor (OR 4.53, 95% CI 2.49–8.26, p < 0.001), while CAD showed a borderline association (OR 2.07, 95% CI 0.94–4.57, p = 0.071). Interaction analysis indicated no statistically significant modification in risk by the combination of anemia and CAD. The composite risk group variable was omitted due to collinearity with its components. Conclusions: Preoperative anemia, particularly in patients with CAD, is a significant and independent predictor of major adverse cardiac events following open AAA repair. These findings support the importance of early identification and correction of anemia before surgery to improve perioperative cardiac outcomes in this high-risk population. Full article